Today I'm going to do a summary of what I learnt during the 2 days conference last weekend. It was an Ambulatory Care HKL Pharmacy Conference. So, here are the facts and figure:
- Medication Therapy Adherence Clinic (MTAC) is also known as Medication Therapy Management (MTM) in USA
- Diabetes in Malaysia 2011: has increase to 20.8% from 14.9% previously.
- 1 of 5 adult Malaysians above 30 years old have diabetes.
- 366 million people with diabetes in year 2011.
- 28% Asians with uncontrolled type 2 diabetes (HbA1c >7%) on OAD & insulin therapy.
- 9.9% world population expected to have diabetes in 2030.
- 130 billion USD spent on diabetes in European region in 2011.
- 44% American with diabetes not at HbA1c target.
- 22% Malaysian with diabetes reaxhed HbA1c target.
- A1c = fasting glucose + postprandial glucose.
- Higher than 10 A1c, preblem is fasting plasma glucose.
- Lower than 10 A1c problem is post prandial glucose.
- A reduction of 1% HbA1c may reduce 37% of macrovascular complication in diabetes patient.
- Immediate use of insulin may improve glycemic control and lower risk of complications.
- Hypoglycemia in diabetes patients can cause heart attack.
- Insulin is meal related.
- Incretin is an intestine secretion insulin (gut derived factor).
- Pancrease; alpha cells reduces hepatic glucose production & beta cells: increase glucose uptake by peripheral tissue.
- Alpha blocker may cause postural hypotension.
- Aspirin can be given as a stroke preventive medication.
- 50% of kidney damage for the creatinine level to rise.
- Tighter Blood Pressure control is more important compared to glycemic control to reduce mortality (death).
- Hypertension treatment reduces cardiovascular events in diabetes.
- Diabetic BP: less than 130/80
- Poor BP control may lead to TIA & stroke.
- Q10 reduces muscle cramps.
- To start anticoagulation meds, use CHADS risk criteria; higher CHADS score, higher chance of stroke.
- Bleeding comparison; warfarin is better than aspirin.
- For asthma treatment, Step down if 3 months without attack; well controlled.
- COPD classification uses CAT (COPD assessment test) score.
An apple a day keeps the doctor away.
Take care of your health as it is very precious for oneself.
Wassalam & Cheers.
